Jody G Long, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3638 Issued in TN

Practice address

1910 Nonconnah Blvd
Suite 120
Memphis, TN 38132-2113

Phone

(901) 448-2300

Fax

(901) 448-6657

NPI assigned

May 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Paradigm Health Services, Inc

  • Mental Health Counselor
  • Clearwater, FL
  • NPI 1578519146

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548228307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N PAULINE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054619",
            "telephone_number": "901-448-8258",
            "fax_number": "901-448-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 NONCONNAH BLVD",
            "address_2": "SUITE 120",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381322113",
            "telephone_number": "901-448-2300",
            "fax_number": "901-448-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JODY",
        "middle_name": "G",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3920189",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christen N Long, B.S.
• Clifford Lee Long, BS
• Diane Long, MD
• Erica Lasha Long, MSN, APRN, PMHNP-BC
• Helen Long, CCC-SLP
• Leslie Long, APRN
• Russell K Long
• Thomas E Long, M.D.
• Vakendall V Long, LCSW
• Longevity Medical LLC

• Clinical Social Worker in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.